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Item Integrating Longitudinal Community-Based Experiential Learning Across Medical School Classes(2024-04-26) Danner, Ana; Syed, Esa; Mann, Gary; Wilhelm, Erik; Neal, ChemenIntroduction/Background: Medical student-led consulting groups facilitate student engagement with the communities they serve while also teaching transferable skills relevant to community outreach, problem-solving, and team-based collaboration. However, maintaining the continuity of projects between successive student cohorts has frequently posed challenges such as changing priorities and a lack of institutional memory. Establishing long-term relationships with community organizations provides students the opportunity to track and assess the sustained impact of their interventions over time and also offers these organizations a consistent source of dedicated support and expertise, reducing the need for repeated onboarding and ensuring that interventions align seamlessly with their evolving needs and goals. To ensure the longevity of our community connections, several solutions can be implemented. Methods: Inspired by initiatives at select medical schools, medical student-led pro-bono consulting groups will collaborate with local organizations to identify vital community needs. Students will work closely with community leaders to design, implement, and assess solutions, offering students real-world experience relevant to their future careers while bettering the community. To ensure a seamless transition across classes for both the students and local partners, the student leaders of the consulting organization would span across each class, allowing upperclassmen to mentor the underclassmen and promoting expertise retention. Executive board elections would be done at the end of the first-year students’ first semester, after they have had the opportunity to participate in an ongoing community project under the guidance of an upperclassman. Detailed transition documents will be maintained in an accessible location. Handoff meetings will be conducted between the newly elected executive member and the outgoing leadership. Outgoing leadership will also facilitate a transition meeting between the incoming leadership and community partner to foster vertical relationships and mutual trust. A committed faculty advisor will be integral to overseeing these transitions. Evaluation Plan/Results: The evaluation process of such a program would ensure that the relationship between the community and the institution is maintained longitudinally. This would be done by having evaluations sent to community partners annually assessing the quality of the institution as a partner as well as the interpersonal communication that has occurred between the institution and community partner. A similar evaluation would also be posed to community members to examine the relationship that the institution has with individuals in the community, which would reveal the impact that the institution may have on the community of which they are inherently a part. These evaluations could then be posed within the institution itself to ask about the value of community member relationships. The culmination of these evaluations would allow for the institution to better evaluate the impact that it has in the community and improve relationships longitudinally for the institution. Additionally, this allows for medical students to develop relationships in the community that will help their peers as well as their own future relationships as physicians in this same community. Potential Impact: By facilitating a seamless transition of leadership within these student-led consulting groups, we will foster more trusting, meaningful, and mutually beneficial relationships with our community partners. Furthermore, by performing regimented evaluations of the quality of these partnerships, we will cultivate robust long-term collaborations.Item The Importance of Safe “Sensitive Exam” Practice in Preclinical Curriculum(2024-04-26) Zuch, Camryn; Schwieterman, Vanessa; Knudson, LauraItem Physician Advocacy and IUSM’s HEAL Competencies: A Comparative Analysis(2024-04-26) Mansouri, Afsheen; Blodgett, Alison; Popoola, Oyesola; Schantz, EliIntroduction: Over the last ten years, the profession of medicine has undergone a reckoning: as our society has been shaped by the Black Lives Matter movement, climate change, and the COVID-19 pandemic, medicine has grappled with how to respond. Indiana University School of Medicine’s new Health Equity, Advocacy and Leadership competency is one such response which is designed to shape, at the institutional level, the attitudes and behaviors of trainees through affirming the importance of advocacy and the role of physicians in making healthcare more equitable. However, the nature of physician advocacy—including both its obligations and limits—remains poorly understood, both in medicine writ large and in the context of medical education. Study Objective: Our goal, here, is to offer a comparative analysis of the skills and knowledge which students are expected to develop in accordance with IUSM’s new HEAL competency, and those which are reflected in the guiding documents of the broader medical profession. Methods: We utilize a qualitative, philosophical approach to accomplish our objective, utilizing the guiding documents of the American Medical Association and the American Board of Internal Medicine (particularly the AMA Code of Ethics Opinions 1.2.10 and 11.2.1 and the ABIM Physician Charter) to represent larger consensus surrounding physician advocacy in organized medicine. We compare the skills, knowledge, and behaviors reflected in these documents with those represented in IUSM’s HEAL competency. Results: The HEAL competency highlights two important points: first, that patients should be treated holistically, and second, that leadership is an important role of the physician in society. However, when we compared the HEAL competency to guiding documents of professional societies, some notable differences were found. While professional societies heavily emphasize the importance of public advocacy and working to change institutions, the HEAL competencies do not address the public arena. Instead, the competencies focus on the physician’s role in demonstrating advocacy through identifying and supporting specific patient needs. In addition, the HEAL competencies emphasize understanding how the social determinants of health impact health equity in patients, as opposed to developing and taking actionable steps to ameliorate those health issues. Conclusion: Physician advocacy will, and should, be a central focus of both organized medicine and medical education in the coming years. However, attempts to integrate education regarding advocacy into the medical curriculum have been hampered by a broader lack of clarity in the obligations and limits of physician advocacy. We have argued here that IUSM’s new HEAL competency is inadequate in emphasizing advocacy as a skill students should develop, especially when compared to the guiding documents of professional societies, which emphasize public advocacy as integral to a physician’s responsibilities.Item Assessing a Longitudinal Educational Experience for Continuous Quality Improvement(2024-04-26) Masseria, Anthony; Birnbaum, Deborah R.We’ll explore the use of assessment tools to promote adaptability and continuous quality improvement (CQI) in a large educational program. The Scholarly Concentrations Program is a statewide program complementing the core medical school curriculum and empowering students to delve into topics of personal interest. The pilot was launched with a “CQI” mindset, and after three years, a robust assessment plan is gathering feedback. While “building the plane as we fly it”, the program has grown from 100 students in its first year to over 400 in its third. A robust, longitudinal evaluation plan is critical. The intended goal is to use this program example to replicate it with other large educational programs anywhere.Item Characterization of a Novel Mutation in the COPI Vesicle on Binding to Dilysine Motifs(2024-04-26) Felipe, Kimberly; Custer, Sara; Androphy, ElliotBackground/Objective: The heptameric COPI coatomer complex is involved in the formation of vesicles and the intracellular trafficking of proteins between the Golgi and Endoplasmic Reticulum as well as throughout the cytoplasm. Members of the COPI complex bind dilysine motifs found in the C-terminal domain of the cargo protein, particularly KKxx or KxKxx. We generated a point mutation in the WD40 domain of the COPI alpha subunit (⍺-COP). We hypothesized that the E269V mutant ⍺-COP would not co-immunoprecipitate (co-IP) COPI cargo proteins terminating with a dilysine domain of KxKxx (Nucleolin and Stasimon/Tmem41b), but would bind cargo proteins terminating in KKxx (FLAG-Syntaxin17). We predicted that a mutation in the ⍺-COP C-terminus, which impairs interaction with ε–COP, would not affect its ability to co-IP dilysine-containing cargo. Experimental Design or Project Methods: HEK-293TT cells were transfected with Myc- tagged wild-type, E269V, and triple mutant (3X) ⍺-COP. The E269V ⍺-COP mutant has an amino acid change at position 269 from glutamic acid to valine. The triple ⍺-COP mutant has three amino acid changes that eliminate binding with the ε–COP COPI subunit. Transfected ⍺-COP was immunoprecipitated using magnetic anti-Myc beads. Endogenous Nucleolin was immunoprecipitated using magnetic Protein A beads conjugated to rabbit polyclonal anti- Nucleolin antibody. Western blots of inputs and immunoprecipitates of each experiment were conducted to determine the ability of ⍺-COP to co-IP C-terminal dilysine-containing proteins. Results: Endogenous Nucleolin and Stasimon co-immunoprecipitated with WT and 3X ⍺-COP, but not E269V ⍺-COP. Conclusions and Potential Impact: The inability of mutation E269V to co-IP dilysine proteins implies that the WD40 domain of the COPI ⍺-COP protein is required for binding to KxKxx- terminating proteins, as typified by Nucleolin and Stasimon.The C-terminal 3X mutation shows that ε-COP is not necessary for dilysine recognition and implies that ⍺-COP directly binds to this KxKxx motif.Item How Girls STEM Institute Impacts Black Girls’ Interest in STEM Careers(2024-04-26) Olumba, Chinonye; Morton, Crystal; Niki Messmore, NikiBACKGROUND Multiple studies show that women, especially Black women are underrepresented in the STEM fields. A factor affecting this outcome is the lack of early career exposure of STEM to Black youth. Girls STEM Institute (GSI) is an organization that encourages girls and young women of color to embrace their innate brilliance through STEM exploration and focuses on the total development of girls’ minds, bodies, and spirits. Through GSI, scholars are provided access to powerful STEM learning experiences such as robotics, aviation, and forensics that challenge them to think deeply and critically. Additionally, the program also gives GSI scholars the opportunity to interact with STEM professionals. For summer 2023, the program served a total of 60 scholars and gave them the opportunity to participate in rich, relevant, and cognitively challenging STEM activities. This study aims to explore what factors affect career interest in young Black girls. METHODS Dr. Morton and the research team administered the Multidimensional Inventory of Black Identity, BEAMMS survey, STEM semantics survey, and Career Interest Questionnaire (CIQ) to all 60 scholars at the beginning and end of the program in paper format. For this study, we focus on the CIQ (N=53 for the pre-assessment. N=47 for the post-assessment) to compare the career interests of the scholars at the program’s beginning and end. A literature review was conducted to better understand Black girls' experiences in formal and informal educational spaces. RESULTS In the post-assessment, there was an overall increase in STEM career interests. The statement “I would like a career in science” had an 11% increase in scholars who agreed, “I would enjoy a career in science” had an 18% increase, and “I will get a job in the science-related area” had a 13% increase. However, 30% were undecided in the “I would like a career in science” section, 30% were undecided on whether they would enjoy a career in science, and 44% were undecided about getting a job in the science-related field. The study is ongoing, and data is still being analyzed. CONCLUSION Young Black girls face various educational challenges and inequities. Nevertheless, science summer programs like GSI create bridges for young Black girls to discover their potential and enhance their confidence to pursue careers in STEM. Traditional educational spaces should follow this example and create a curriculum that is aware of the needs of Black girls.Item Peripheral Neuropathy in Long-COVID Patients: Demographic Distribution and Comorbid Risk Factors(2024-04-26) Li, Jason; Bohn, Camden; Todd, Noah; Pater, Jessica; Carroll, Jeanne; Henriksen, Brian; Chang, Fen-LeiItem Visual Analytics for Data-Driven Understanding of the Substance Use Disorder Epidemic(2024-04-26) Qaurooni, Danial; Herr, Bruce W; Zappone , Sarah Renee; Wojciechowska, Klaudia; Börner , Katy; Schleyer , TitusThe substance use disorder epidemic has emerged as a serious public health crisis, presenting complex challenges. Visual analytics offers a unique approach to address this complexity and facilitate effective interventions. This paper details the development of an innovative visual analytics dashboard, aimed at enhancing our understanding of the substance use disorder epidemic. By employing record linkage techniques, we integrate diverse data sources to provide a comprehensive view of the epidemic. Adherence to responsive, open, and user-centered design principles ensures the dashboard's usefulness and usability. Our approach to data and design encourages collaboration among various stakeholders, including researchers, politicians, and healthcare practitioners. Through illustrative outputs, we demonstrate how the dashboard can deepen our understanding of the epidemic, support intervention strategies, and evaluate the effectiveness of implemented measures. The paper concludes with a discussion of the dashboard's use cases and limitations.Item How do Internal Medicine Residency Program Websites Signal their Inclusion of LGBTQIA+ Applicants in the East North Central Region?(2024-04-26) Gribbin, Will; Baker, Brittany; Peterson, Ellen; Anak Ganeng, Brenda; Byram, JessicaItem MSK PoCUS Training for Rural Clinics(2024-04-26) Smeltzer, Kathryn; Tollar, Roarke; Cook, Myanna; Wilcox, James; Ireland, EllenINTRODUCTION: Point of care ultrasound (PoCUS) is a portable diagnostic technology with broad applicability, no radiation, and is less expensive than alternative imaging methods. PoCUS is emerging as high utility technology to expand bedside physical exams for primary care practitioners. Access to medical care in rural areas is an ongoing issue, especially for specialty care. By using PoCUS, rural providers may be able to more completely screen for conditions and determine if patients will need to seek specialty care, such as orthopedic intervention, which is often more time consuming for rural patients. OBJECTIVES: This study is to identify barriers to learning and using point of care ultrasound technology for rural primary care practitioners for expanded examination, including for orthopedic applications. The secondary objective of this pilot study is to evaluate the best practices of expanding rural PoCUS training. METHODS: The team identified six rural primary care practitioners at outpatient clinics around Indiana. Grant funding was used to equip these clinics with portable ultrasound probes with PoCUS-software-equipped iPads. Training consisted of approximately one hour of independent didactic material and two hours of in-person hands-on training with our investigators and students. Initial surveys were collected before and after the in-person training session. After a few months of individual practice, teleguidence training sessions were offered to the participants. Post-training surveys will be collected approximately six months after the initial training session. At this time, the first and second surveys for the six physicians have been analyzed and provide preliminary results. RESULTS: The pre-training survey from the six physicians before the in-person training session found that previous PoCUS experience of these physicians varies greatly, and nearly all of these practitioners have not used ultrasound in their clinic within the last year. This survey also showed unanimously that these physicians make orthopedic diagnoses in their practice but do not feel comfortable using ultrasound in supporting these diagnoses, showing the potential for PoCUS in their clinical practice. The second survey results have shown that even after just two hours of training, the physicians are comfortable with using ultrasound to support their orthopedic diagnoses, to the point that the majority are also somewhat comfortable teaching this material to others. All of the physicians agreed that the independent didactic material supplemented the in-person training, which supports both the quality and platforms provided for this material. The enthusiasm and improved confidence after the training sessions also support the quality of our investigators’ in-person training sessions. Though it was not difficult to recruit physician participants, one of the biggest obstacles this study faced was scheduling the in-person training session. CONCLUSION: Implementation of PoCUS in rural clinics for the evaluation of orthopedic diagnosis was met with enthusiasm and has shown potential for streamlining evaluation at specialty clinics. Major barriers to adopting this technology include finding adequate time for medical practitioners to learn and practice using the equipment and scheduling live, on-going training.